State of the State: California Disability Policy in 2024

Several disability-led organizations have formed the California Disability Leadership Alliance to influence and improve policies for disabled people in California. Together, the Alliance and disability partners created this State of the State report, which provides an overview of California’s gaps in disability rights in areas like health care, education, transportation, employment and housing. The goal of the report is to shine a light on the inequality in state legislation and enforcement and work towards a more equitable future for all Californians with disabilities.

California has long led the nation in policies that advance civil rights and equity. However, for the 7.6 million disabled adults[1] and 1.4 million disabled children[2] in the state, equity remains out of reach. When compared to other states, California has among the highest housing and health care costs, with low disability employment and high rates of poverty among disabled people.[3] Disabled people lack equal access to civic engagement opportunities, with inaccessible voting systems, inadequate transportation, and lack of accommodations for public participation in government meetings.[4]

To claim the title of leader, California must assess its gaps in disability rights, both in statute and enforcement. From disaster preparedness to policing, California policies need to not just catch up, but step ahead of the norms and embrace disability equity.

By providing a high-level overview of these gaps, this report identifies the many issue areas in which lawmakers, state agency leaders, and advocates may collaborate to introduce and enact disability-specific legislation and rules that advance disability community interests. We view this report as a tool for organizing the array of public policy reforms needed to address the complex problems facing disabled Californians.

While the overview here covers many broad issue areas, our recommended approach is relatively simple. First, listen to disabled Californians when developing solutions for policy problems that affect them. Second, center the valuable lived experience of disabled Californians to find solutions to the problems. Through the direct engagement of disabled people, both within leadership and in communities throughout the state, we can create a disability-inclusive California.

Mental health services are trending towards criminalization rather than care, threatening the progress of the peer movement.

This November will mark 20 years since California voters passed the Mental Health Services Act (MHSA). Since then, $31 billion has been raised through the Act’s 1% tax on incomes above $1 million. After some significant delays, that money began funding vital community mental health services.

These funds succeeded in increasing investment in peer support and recovery-oriented treatment. These investments have reaped benefits beyond the services themselves. For example, people who recovered their lives through appropriate services funded by MHSA have chosen to help others in crisis.[5] A growing peer support workforce enables increasing numbers of people to benefit from recovery-oriented treatment. That, in turn, leads to more people wanting to join that workforce.

In 2020, California formally recognized the importance of peer support by enacting legislation to certify peer support specialists as a new category of health workers. The legislation also made peer support a covered Medi-Cal benefit. California now has 2500 certified peer support specialists.

However, the new wave of coercive, punitive mental health laws threatens the progress made by the MHSA and the peer movement. A series of new policies, including CARE Court, SB 43, and Proposition 1, push the system towards carceral approaches to addressing mental health needs. These policies rely on a narrative that people with mental health issues are not taking care of themselves and must be pushed into treatment; however, community mental health options are severely lacking, along with the housing needed for people to stabilize their lives. These programs are even more concerning considering other attempts to criminalize homelessness and disability in California, as described later in this report. Our current system is far from perfect, but we need to focus on expanding what works: voluntary, culturally competent services in the community.

Court-ordered treatment is expanding.

In 2022, California enacted CARE Court. The legislation applies to people with schizophrenia or other psychotic disorders but was oversold as a program to help people with mental health disabilities who are unhoused. CARE Court permits almost anyone to file a petition against another person and provides no housing guarantees, leading to an ineffective and coercive system of services. Peer-reviewed research has repeatedly demonstrated that court-ordered mental health treatment is not more effective than voluntary treatment.[6]

The results of CARE Court thus far show that it is based on a false premise that large percentages of unhoused people are unhoused because they live with schizophrenia spectrum disorders and refuse treatment or social supports. The number of participants is far below the expected uptake, and the demographic data we have seen already shows racial inequities. CARE Court funding, which is expected to reach about $300 million a year for implementation, funds the court system, not services or housing. Ultimately, CARE Court is a burdensome and costly program that misses the mark on addressing mental health and homelessness.

New laws expand involuntary holds for people with mental health disabilities.

Legislation enacted in 2022 added a second 30-day involuntary hold to existing statutory 72-hour, 14-day, and 30-day holds. These extended involuntary holds keep people in locked facilities rather than in the community, remove civil rights and civil liberties, and increase the risk that the person will be subjected to a longer, virtually permanent conservatorship.

Legislation enacted the following year takes further steps to subject people with mental health disabilities to involuntary holds in locked settings. The 2023 law expands the definition of “gravely disabled” and allows the hearing officer to consider evidence previously inadmissible. The expansion of involuntary holds creates additional pathways to conservatorships, which restrict the rights of people with mental health disabilities.

“Modernization” is a step backward.

Passage of Proposition 1 in March 2024 has the potential to disastrously expand forced institutional treatment for Californians with mental health disabilities. Prop 1 reallocates 30% of MHSA funds towards housing interventions and requires that existing funds serve an additional population: people with substance use disorders. This means that programs providing mental health services, such as programs serving racial, ethnic, and linguistic minorities, will see cuts. Disabled Californians are entitled to appropriate community-based permanent housing and mental health services. We reject the idea that people with substance use disorders and mental health disabilities need to be pitted against each other for the same funding, as this initiative does. California needs to adequately resource mental health and substance use disorder services rather than forcing marginalized groups to compete for limited funds.

Further, the dollars from the bond measure in Prop 1 could go to short-term treatment beds including expensive locked institutional settings. Locked facilities frequently violate disabled peoples’ rights, and coercive treatment practices are less effective than voluntary treatment, which is currently woefully underfunded across the state.

This initiative is a step in the wrong direction. Rather than funding programs that already work and should be expanded, the governor is imposing a top-down system that does not consider specific community needs.

The 2024-2025 budget contains further cuts in behavioral health, such as behavioral health bridge housing, youth behavioral health programs, and CalWORKs mental health and substance abuse services. If the governor truly wanted to “modernize” California’s mental health system, these programs would be growing, not facing cuts.

High rental costs disproportionately harm people with disabilities.

The high cost of living in California is impacting most Californians, and the pain is acutely felt by Californians with disabilities. Californians with disabilities disproportionately live in poverty.[7] Many rely on Supplemental Security Income (SSI) of less than $1000 per month and cannot afford to live in any California rental market without additional subsidy.[8] The state can do more to reduce housing costs by:

• Creating a universal basic rental income program or cash assistance for housing that goes directly to the renter. This reduces the administrative, financial, and other additional costs of providing rental payments directly to landlords while providing greater housing choice.[9]
• Supporting efforts to supplement federal housing voucher programs with statewide voucher entitlement for people making 30% of the area median income or less. Currently, over 50% of California’s Section 8 voucher households have at least one member with a disability.
• Considering a disability rent increase exemption.

California needs to be a leader on disabled tenant rights.

Californians with disabilities often face evictions from their homes, which can have devastating consequences for health outcomes. The state can ensure disabled tenants remain in their homes or obtain one by:

• Requiring the Judicial Council to provide clearer guidance to courts and their ADA Coordinators regarding the obligation to reasonably accommodate individuals and clarify that accommodations must be considered even if they are not requested.
• Repealing Costa Hawkins, which prohibits rent stabilization ordinances for buildings built after 1995. Principles of universal design and the use of ADA architectural guidelines for housing remain rare, and the use of these design principles does not predate 1990. Therefore, the majority of housing units that are accessible are also the same units that cannot be subject to rent stabilization. We recommend a strong statewide rent stabilization policy to protect disabled Californians, many of whom are unable to afford the rental market without subsidies which frequently do not keep up with the rate of rental inflation.
• Funding housing transition and tenancy maintenance services.
• Creating a statewide security deposit fund for prospective tenants without rental history or resources.
• Appropriately funding the Civil Rights Department to enforce California’s fair housing laws, particularly around source of income discrimination, which has been illegal since 2020. Enforcement efforts to date have been underwhelming due to a reported lack of resources, despite the existence of widespread discrimination. For example, the State contracted with a fair housing organization to do testing in Los Angeles for Section 8 discrimination. Of 80 properties tested, 47.5% found Section 8 discrimination.[10]

California must stop criminalizing homelessness.

Carceral responses to homelessness are demonstrably ineffective. However, California cities and counties have increasingly passed ordinances seeking to criminalize unhoused people. California is home to approximately 30% of the U.S.’s unhoused population, a disproportionate number of which have disabilities.[11] California should be a leader in responding to this human rights crisis, not by fining and arresting folks, but rather, by focusing on root causes of homelessness, harm reduction, and permanent, stable housing, without the use of force or other means of coercion.

The 2024 Supreme Court Decision Grants Pass v. Johnson ruled that cities can further criminalize homelessness by punishing people for sleeping in public.[12] Governor Newsom chose to embrace this ruling, ordering local governments to sweep encampments without any assurance that people will receive housing.[13]

Sweeps do not solve homelessness. In fact, they worsen conditions for disabled unhoused people trying to find shelter. Sweeps regularly separate unhoused people from documents needed to obtain services, such as their IDs, medications, harm reduction supplies such as Narcan, and mobility aids.[14] Documentation of a recent sweep of an encampment in San Francisco showed several mobility aids, including wheelchairs and a walker, confiscated from unhoused people.[15] This is particularly egregious in light of how few shelters or temporary motels are accessible to disabled people. Unhoused people need housing, not sweeps.

Over-policing endangers disabled people across California.

California has invested more than a billion dollars in responding to the state’s “crime problem”. However, data pointing to increased crime in California are muddled at best, with crime rates statewide near record lows.[16]

In response to these reports of increased crime, and with hundreds of millions of dollars from the state,[17] communities across the state have hired many more police officers. For some Californians, this makes them feel safer, but for others, it sparks fear and anxiety. Black, Indigenous, and other people of color, including disabled people of color, are disproportionately likely to be subject to negative interactions with police officers and other representatives of the criminal legal system.[18] California must be intentional about the use of law enforcement and should invest in programs that provide communities with social and economic opportunities.

When police respond to behavioral health crises, they harm disabled Californians.

For decades, Californians in mental health and other disability-related crises have been seriously injured or killed by police responders.[19] While resources have been put into training police officers, these fatal interactions continue. In many of these circumstances, a trained non-police mental health response team could have de-escalated the situation without harming the disabled person. California needs to fully invest in these clinical response teams, which have seen success in some parts of the state. The rollout of 988 presents an opportunity but mental health services must be resourced so they can respond to 988 calls. Adequate access to mental health and other disability services also prevents crises.

California must ban solitary confinement for people with disabilities.

Disabled Californians are dramatically overrepresented in carceral settings like juvenile detention, jails, prisons, and immigration detention. These settings are typically brutal for every incarcerated person but are in many ways worse for disabled incarcerated people. People with disabilities are placed in solitary confinement — a form of torture that injures and kills — at high rates and for periods of time that can continue for months — even years.[20] Solitary confinement has been recognized by the United Nations, World Health Organization, and other international bodies as greatly harmful and potentially fatal. People with disabilities, pregnant people, youth, and older adults are all at heightened risk from the harm caused by solitary confinement inside jails, prisons, and immigrant detention centers in California. California must pass the Mandela Act, which will ban solitary confinement for specific populations and set limits on this harmful practice.

We lack adequate data to understand and address hate crimes against disabled people.

Hate crimes in California have been on the rise for nearly a decade, impacting Black, Latinx, and Asian Californians most. In short periods, anti-Black, anti-Latinx, and anti-Asian hate crimes increased by 156% overall from 2019 to 2022.

There are significant problems with the reporting system that California uses to track hate crimes. For example, according to the Statista research department, in 2021, California only had 81 hate crimes total,[21] which experts believe to be an undercount. The state must have a better reporting system that accurately counts these crimes to better protect disabled Californians.

The recent US Bureau of Justice Statistics and FBI data reports that only 0.4% of all hate crimes are against people with disabilities. Anecdotal data suggests that this is an undercount. Reasons for the inadequate data include police are not able to recognize disabilities, victims and witnesses do not report to the police in the first place,[22] and when someone has intersectional identities, often only one identity is reported. California must prioritize the most vulnerable and ensure that hate crimes are being tracked properly so that we can make sure these crimes stop happening.

School staff shortages worsen conditions for disabled students.

Schools are continuing to recover from staff shortages that have been exacerbated by the pandemic and stagnant wages. Despite the recommended ratio of 250 students per counselor, California school counselors report caring for an average of 527 students, according to the American School Counseling Association.[23] There is a significant shortage of qualified teacher aides, which many students with disabilities rely on to access a free and appropriate public education (FAPE) guaranteed in the Individuals with Disabilities in Education Act (IDEA). Without sufficient classroom aide staffing teachers are stretched thin, students lack the support they require, and districts must attempt to fill the gaps with contract agencies which sometimes provide aides with little training.[24] In addition, California is experiencing a teacher shortage, with more than 10,000 teacher vacancies in the 2021-2022 school year. The shortage is particularly concentrated in rural communities, low-income communities, and communities of color. Further, there is a severe shortage of credentialed teachers for Deaf students and for blind and low-vision students.

The Governor’s 2024 Budget does not provide much hope, as the lack of substantive increased support for educators results in little incentive for special education teachers and providers to remain in or enter the field. For children and youth with disabilities to be adequately served, work remains to retain and recruit staff who can assist them and ensure all the services agreed to in Individual Education Plans (IEP) are delivered to the students who require support.[25]

Law enforcement involvement endangers disabled students.

While the State of California leads in preventing suspensions of students for willful defiance, students with disabilities continue to face punitive measures for behavior, often involving law enforcement. Ideally, school staff would be able to address the specific issue a student faces and prevent law enforcement interaction.

Students with disabilities are disproportionately impacted by the school-to-prison pipeline. According to the 2024 Racial and Identify Profiling Act Report, officers are more likely to search, detain, and handcuff students with disabilities. For example, officers handcuffed students with disabilities 41% of the time they were stopped, compared to 15% of students without disabilities. Additionally, the California Division of Juvenile Justice (DJJ) estimates that 25% to 30% of DJJ youths have been identified as requiring special education services.[26] California must ensure that teacher shortages and antiquated laws do not translate to increased harmful law enforcement interactions for California’s youth.

California participates in the “Troubled Teen Industry.”

The “Troubled Teen Industry” (TTI) is a term for the different facilities for “troubled youth” and is a multi-billion-dollar industry in the United States. One of the states with the largest TTI is Utah, which houses close to one hundred youth treatment centers that together gross nearly five hundred million dollars ($500,000,000) per year.[27] In 2020, California youth were sent to eight different facilities in Utah. In 2022, after a state law was passed prohibiting out-of-state placement of systems-involved youth (from foster care and juvenile justice systems), California youth were still sent to a total of three facilities, two of which were in Utah.[28] The exact number of youth sent to Utah and other states’ facilities is unclear, as the California Department of Social Services masked values of ten or less when providing out-of-state placement information through the Interstate Compact on the Placement of Children. In any event, these totals do not include youth sent via the education system or those privately placed by caregivers.

Additionally, following the prohibition on out-of-state placements for systems-involved youth, Disability Rights California (DRC) has received concerning reports of county foster care agencies collaborating with school districts to funnel foster youth to these facilities through the IEP process. We are gravely concerned that vulnerable youth are being moved to facilities without accountability rather than being accommodated by the school system.

Inclusive education is still not the norm in California schools.

In California, there is a legal presumption in favor of educating students with disabilities along with students without disabilities. Students must be educated with other non-disabled students unless the nature and “severity” of the disability is such that education in a regular classroom cannot be achieved reasonably.[29] Despite aggressive statewide targets adopted by the State Board of Education in 2021 for increasing the time students with disabilities in preschool-12^th grade spend in the general education curriculum, California has only made small gains toward its goal of greater inclusivity and belonging. By next year, hundreds of local educational agencies (LEAs) will not have met the statewide goal of 70% of students with disabilities spending 80% or more of their time in general education. Research has shown that the level of inclusion a child experiences beginning in preschool is a strong predictor of whether they will be included in general education in later grades.[30]

The enacted 2024-2025 budget reflects a decision to roll back the inclusion of disabled children in the state preschool program to a mere 5% of the student population. Similar programs, including the federal Head Start program, dedicate at least 10% enrollment to disabled students. The state needs to provide opportunities for our youngest children with and without disabilities to be educated in inclusive settings with robust support and services to ensure the stage is set for inclusion and belonging in our schools and communities from the beginning of a child and family’s journey. Ensuring there is appropriate funding designated to support students with extensive support needs in more inclusive settings would also signal the state’s commitment to inclusion.

Language and Communication Access needs to be the heart of Deaf Education.

Language and communication are central to Deaf children’s cognitive, emotional, and social development. Early language exposure is critical for Deaf infants and toddlers to acquire language and a solid foundation that will lead to the development of literacy skills. To monitor and ensure language development, ongoing assessments that track the Deaf child’s language developmental milestones are needed in early intervention. Whether Deaf students are using American Sign Language (ASL), spoken English, or both languages, determining how to provide Deaf students with a Free and Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE) is nuanced and complex. As stated by the National Association for the Deaf (NAD), the Least Restrictive Environment for Deaf and hard-of-hearing children should have the fewest language and communication barriers to their educational development.[31] However, the LRE has historically and continues to be misapplied to justify placing Deaf and hard-of-hearing students in general education without support or access to language and communication. These risks and challenges are inherent in the full inclusion movement. It is necessary to have credentialed teachers of the Deaf and knowledgeable administrators to ensure Deaf students have appropriate support and access to language and communication. For these reasons, Deaf advocates must be at the table when discussions about disability education and Deaf education are occurring.

Inclusion is complex — ultimately, decisions should center the preferences and learning needs of the person with the disability. For example, some students in the blindness community may benefit from or prefer a specialized educational setting. Teachers and other educational professionals who have specialized training and certifications are necessary for appropriate instruction of pupils who are blind or have low vision. For a variety of reasons, including teacher shortages, especially in rural districts, the local school district may not be the least restrictive or most appropriate setting in which children who are blind or have low vision can make educational progress.

California falls behind other states in disability employment.

California prides itself on being an “Employment First” state. Employment First is a framework centered on the premise that all individuals, including those individuals with the most significant disabilities, are capable of full participation in Competitive Integrated Employment. In 2021, California enacted a law requiring state agencies to accommodate people with disabilities and to adopt and implement affirmative action plans to improve the representation of individuals with a disability.

Despite these paper commitments, the employment rate of disabled workers in California state government has steadily dropped from 12.1% in December of 2017 to 7.1% in June of 2023 — a 40% decrease.[32] This is far below the 16.6% employment rate reported by the federal government in 2022. Moreover, unlike the federal government, California does not collect or report data on people with the most significant or “targeted” disabilities. California’s low numbers likely reflect failures in recruitment, hiring, workplace culture, employment support services, reasonable accommodation, and retention.

Additionally, California should pursue opportunities to supply education, training, and funding for employers on reasonable accommodations, including website and online application accessibility for people with print disabilities. Small business owners and those with limited capital deserve the opportunity to develop and provide reasonable accommodations that can support disabled people who are skilled, willing, and able to participate in our workforce.

The push for in-person work is leaving disabled workers behind.

As the public and private sectors push for return-to-office policies, many disabled employees are being left behind. Remote work is a reasonable accommodation that many disabled people utilize. People with some types of mental health conditions, autism spectrum disorders, certain chronic health disabilities, and certain physical disabilities have had to bear the brunt of this shift from remote work to the in-person work setting. Unfortunately, many managers have little or no understanding of certain types of disabilities and tend to attribute requests for legitimate reasonable accommodation to faking or malingering.

We have heard numerous reports of accommodation requests being delayed or denied. Further, we are concerned by the fact that employees who have requested reasonable accommodation, and who are waiting for their requests to be processed or adjudicated, are being told to report to the physical work setting or use leave credits to continue working remotely. Remote work must be considered as reasonable accommodation when appropriate for the role, and accommodation requests need to be considered individually rather than blanket denials.

Additionally, California should pursue opportunities to supply education, training, and funding for employers on reasonable accommodations. Small business owners and those with limited capital deserve the opportunity to develop and provide reasonable accommodations that can support disabled people who are skilled, willing, and able to participate in our workforce.

Vocational rehabilitation services fall short of meeting the needs of disabled people who want to work.

Disabled individuals who receive pre-employment services through the California Department of Rehabilitation have reported significant time delays that impact their academic and job prospects. The state needs to streamline the process of procurement of resources, delivery of services, and intake of new clients to ensure that disabled individuals benefit from these programs in a timely manner for their job readiness.

Further, many rehabilitation training services are delivered through community partner agencies purporting to have expertise in the unique training and skill needs of particular disabilities. Most of these non-profit community partner agencies being funded for their expertise often lack any representation by those persons with disabilities on their boards or management teams.[33] Just as with the funded Independent Living Center entities, community partner agencies funded by state vocational rehabilitation dollars should have mandatory quotas of persons with disabilities represented in their management structures.

The ASL interpreter shortage is a barrier to Deaf inclusion in employment, higher education, and beyond.

California needs to invest in the professional development of ASL interpreters. In 2022, the National Deaf Center (NDC) on Post-Secondary Outcomes stated that the lack of ASL interpretation is currently creating a crisis among Deaf and hard-of-hearing college students. The interpreter shortage is not only impacting Deaf people in college education but also in elementary through high school education, the court systems, healthcare, employment, and other areas. Rural areas that have only a handful of interpreters often do not have robust broadband internet to use video remote interpreting (VRI). While VRI helps make effective use of limited resources, VRI still depends on having enough qualified and diverse ASL interpreters.

Disabled workers need access to services and supports that are not linked to poverty-level income thresholds.

Many services for disabled people are income-limited. Disabled people are forced into an impossible choice: remain in poverty and receive services, or work and jeopardize needed services. In many cases, even with an income, an individual cannot afford to pay for needed services out of pocket, nor should they be expected to. This contributes to the high unemployment rates of people with disabilities in California, and elsewhere in the nation. Notably, at the federal level, the SSI asset limit prevents many disabled people from taking on paid work.

California should do more to decouple services and income. If people do not qualify for Medi-Cal or regional center services, there are few options for long-term services and supports. With a few exceptions, Medi-Cal eligibility requires disabled people to remain in poverty. California should be a leader in disability employment and create pathways to long-term services and supports (LTSS) for employed people with disabilities at every income level. One policy lever to achieve this goal is a Medicaid buy-in program for working disabled people across incomes.

Barriers to HCBS waivers reduce access to services needed to live in the community.

There are currently unnecessary and unlawful barriers to accessing the Home and Community-Based Services for the Developmentally Disabled (HCBS-DD) Waiver. This issue has become particularly acute given the massive HCBA waiver waitlist and the inability of medically fragile children to access Medi-Cal services without institutional deeming, as well as the need for nursing and other services for individuals who have recently aged out of Early and Periodic Screening, Diagnostic & Treatment (EPSDT).

The waiting list for the Home and Community-Based Alternatives Waiver traps medically fragile children in hospitals and institutions.

California is a leader in the nation in Medicaid (known as Medi-Cal in California) expansion; however, the failure to ensure capacity for the Home and Community-Based Alternatives (HCBA) Waiver keeps children in hospitals and pediatric subacute facilities, when this waiver is their only pathway to Medi-Cal. Increasing HCBA Waiver capacity will also ensure that people with disabilities and older adults who need services from the program, including those with Alzheimer’s and dementia, can live in their own homes and communities.

Further, the rates for the HCBA waiver have not increased in 15 years. The Centers for Medicare and Medicaid Services (CMS) requires states to evaluate and update their rates at least every 5 years, but that has not happened in California. The lack of updated rates further reduces access to services by contributing to difficulty in recruiting and retaining an adequate workforce. The workforce shortage jeopardizes the health and well-being of children and adults with disabilities and threatens to undo decades of success and progress in the disability movement.

The California Community Transitions Program remains temporary.

The California Community Transitions (CCT) program is part of the federal demonstration project, the Money Follows the Person Program.  Established in 2007, CCT made funding available to help low-income people with disabilities and older adults transition from skilled nursing facilities (SNFs) back into their own homes. Rates for CCT have been flat since the program started in 2007, meaning that there have been no adjustments to rates in 16 years to account for inflation and increases in labor costs. Meanwhile, the Medi-Cal reimbursement rates for skilled nursing facilities have increased by nearly 70% during that same time, even though these facilities have failed to meet the needs of disabled residents, especially those with vision or hearing loss. In fact, skilled nursing facilities are not required to collect data concerning people with disabilities to ensure they are receiving quality and equitable care.

Decades of underfunding home and community-based services, like CCT, places low-income seniors, and people with disabilities at risk of unnecessary institutionalization. CCT is an integral part of the State’s ability to fulfill its obligation under the Olmstead decision to provide integrated services and supports to disabled people.

In California, however, without adequate financial commitment to HCBS, equity is elusive. Additionally, underfunding HCBS is particularly impactful for underserved communities of color. Failure to invest in CCT and address these low rates prevents California from realizing the goals of the Master Plan for Aging, and Governor Newsom’s recent Executive Order, N-16-22, enacted in part to reflect “that confronting inequality is not just a moral imperative, but an economic one.”[34]

Failure to address low provider rates likewise imperils the CalAIM Incentive Payment Program — without sufficient provider rate increases, capacity building cannot happen. Critically, HCBS Waiver programs and programs like CCT ultimately save the state millions of dollars by avoiding unnecessary institutionalization. The CCT program must be made permanent, with the infrastructure and rates needed to ensure that adults with disabilities and seniors have an opportunity to transition back to the community with the least number of barriers.

Long overdue In-Home Supportive Services (IHSS) changes are finally happening, but more changes are needed.

On June 1, 2022, the California Department of Social Services (CDSS) issued guidance making clear that immigrants with sponsors should not be denied IHSS benefits because of their sponsor’s income, as long as they are Medi-Cal recipients and meet all other eligibility. The new guidance also made clear that undocumented immigrants receiving Medi-Cal are eligible for IHSS, regardless of immigration status, including undocumented immigrants 50 and older who are newly eligible for full-scope Medi-Cal following the Older Adult Expansion. The Governor proposed to eliminate this benefit for undocumented immigrants earlier this year, but the Legislature understood the harm of this proposal and rejected it.

On December 21, 2023, CDSS released guidance implementing changes in state law that remove restrictions on when parents can be paid IHSS providers for their minor children with disabilities. These changes also eliminate unnecessary barriers to hiring a non-parent provider and ensure that children with disabilities in California can access the caregiving services they need to remain living safely at home.

This important new guidance is the result of years of advocacy led by disability organizations to end state policies strictly limiting access to services for minor IHSS recipients. Before these changes, parents could only be paid providers if there was no other suitable provider available and the parent was prevented from full-time employment due to the care needs of the child. A non-parent provider could only be hired if parents were not able or available to care for the minor child, among other eligibility requirements. The changes to state law and new guidance eliminate these restrictions, effective February 19, 2024.

These changes also address longstanding inequities impacting minor recipients living with a parent who does not have satisfactory immigration status. Under the old rules, children who were eligible for, and needed IHSS, were denied services based on their parents’ immigration status. As a result, these children went without any services at all, no matter how great the need. Under the new guidance, their authorized IHSS hours may now be covered by a non-parent provider.

IHSS still needs some reforms to better serve certain disability groups. For example, IHSS recipients who are blind, low vision, or have other print disabilities need access to written information and assistance in filling out documents. However, despite 40 years of advocacy, the state has refused to include reading of, and assistance filling out documents as an IHSS-covered service. This long-standing problem needs resolution by covering this service in the IHSS program.

People who need significant personal care assistance continue to face unfair limits on life choices.

People with disabilities whose income is above the level required for Medi-Cal eligibility frequently privately pay thousands of dollars annually for the personal care assistance and in-home services that they need to live independently and maintain their well-being. Personal care and other out-of-pocket health care costs will only increase as individuals age and acquire health conditions and potential additional disabilities.

Many disabled people who are part of this invisible population will never be able to afford retirement without being forced to risk institutionalization because of an ongoing need for personal care assistance, combined with the fact that a lifetime of work may result in retirement income that is above Medi-Cal eligibility levels. This is especially the case for disabled individuals who do not qualify for regional center services because their disability is not developmental.

Similarly, marriage can affect eligibility for Medi-Cal, through eligibility rules tied to a spouse’s income or assets or, in the case of Disabled Adult Child Medi-Cal, for example, the fact of marriage itself. These outdated rules can even affect couples with levels of income far too modest to afford privately paying for necessary personal care assistance and home chore services while meeting their other basic needs.

The Lanterman Act Entitlement does not live up to its promise.

The Lanterman Act entitlement was visionary in 1977, granting people with intellectual and developmental disabilities (I/DD) broad access to needed services. Today, despite the entitlement, people often wait months for services or are denied services that they need to meet their goals. Workforce shortages, inadequate person-centered planning, and perceived scarcity contribute to people with I/DD going without the services they need.

With California’s 21 regional centers each implementing the Lanterman Act in their own way, people with I/DD experience the system differently based on their region, or even their individual service coordinator. More oversight and standardization can help bring all regional centers up to a higher standard. The expertise of people with I/DD who receive services must be at the table to inform and correct both gaps in service and a critical lack of equity for underserved communities.

Systemic racism continues to create barriers to services.[35]

Regional centers do not distribute services equitably to the people they serve. People of color receive about half as much per capita spending on their services compared to people who are white. Many systemic factors contribute to this disparity. For example, administrative burden unequally affects consumers of color, and lack of language access stands in the way of equal access to services. The I/DD service delivery system must embed equity in every policy and practice and work to reverse the detrimental effects of systemic racism within the system.

People with I/DD lack real choices about where to live.

The HCBS Settings Rule says people have a right to make choices about where to live, like choosing between disability-specific and non-disability-specific settings. However, many people with I/DD are not given this choice today. Instead, options like group homes are assumed to be the best fit for people. In particular, systems-involved individuals and people with co-occurring I/DD and behavioral health conditions are often placed in restrictive, small congregate settings where they do not get to make their own choices about their lives.

In fact, California scores below the national average on measures of how much choice and control people with I/DD have over their lives.[36] Two factors that contribute to this lack of choice are:

• Lack of housing affordability and accessibility, with no housing markets in California being affordable to people on SSI.[37]
• Lack of services for people with complex needs to live independently in less restrictive environments.

California must embrace the HCBS Settings Rule going forward by offering true choice to people with I/DD, regardless of co-occurring conditions or perceived severity of need.

Communication access needs to be uplifted and expanded.

Communication should not just be an accommodation; it should be the expectation. With the invention of the iPad, Augmentative and Alternative Communication (AAC) devices are now more readily available with funding from the systems that serve individuals with disabilities. However, owning an iPad does not in itself make you a communicator. Systems must consider how an individual will access their communication and the supports needed to provide equitable access. For some, this may require a support person who can provide sensorimotor regulation, assist in programming technology, hold a keyboard or low-tech letter board, transcribe communication, and more. State agencies like DDS and DOR often overlook these complexities of communication access and assume that providing an AAC device is equivalent to speech.

Communication is a human right that, for some individuals, may require training from a qualified AAC specialist for the individual and their caregiver(s). This support should not be a barrier to living a self-determined life, but often it is.

These agencies need to make these changes to support AAC users:

• Ensure every individual has their choice of communication. This may require an assessment with an AAC specialist and other professionals who will consider how communication can be accessed.
• Honor an existing and established mode of communication without question.
• Provide communication training and support(s) as separate service(s) to both the individual and their circle of support.
• Ensure equitable access to meetings both public and private with the accommodations an individual requests. Some examples may include extra time to comment, additional staff support hours, enabling the chat, or a meeting moderator who can read their input for virtual platforms.
• Collaborate across systems to ensure communication accessibility is consistent. ADA requirements for effective communication state that “When choosing an aid or service, Title II entities are required to give primary consideration to the choice of aid or service requested by the person who has a communication disability.” As such, giving an AAC user the right to choose and the accessible supports they require is the responsible thing for the systems that serve them to do.
• Collect data on disabilities that affect communication. Access and support to communication tools and trained support staff are not currently identified or tracked by any state or federal agencies.

Without communication access and support in education, employment, or housing the freedom and independence to choose is impossible. Living an authentic life is impossible without authentic communication.

Californians continue to experience accessibility barriers in health care settings.

Inaccessibility is pervasive in health care settings. For example:

• A California-based study conducted comprehensive in-person site inspections of 2,389 primary care offices found that only 53% of provider sites met all parking/exterior access criteria, 56% met all building entrance and interior public areas access criteria, and just 34.3% met all interior office and restroom access criteria.^[38] This same study found that medical equipment was the most pervasive area of inaccessibility, with only 8.4% of offices having an adjustable height exam table and only 3.6% having an accessible weight scale.
• Medical diagnostic equipment such as mammography machines often lack the adjustability and spatial configuration needed to accommodate women in wheelchairs, making it difficult to position them properly for imaging. This results in many people not being able to receive mammograms in the seated position. The lack of accessible diagnostic equipment contributes to significant disparities in healthcare access for people with disabilities, leading to poor health outcomes​.
• The increased reliance on online portals, forms, and virtual platforms for medical services creates disparities in access and delivery for people who rely on screen reading software. This underscores the need to enforce accessibility standards to ensure equitable healthcare for all.
• Deaf individuals still struggle to get ASL interpreters for healthcare appointments and procedures. Video Remote Interpreting, when not fraught with technical issues, is not effective for all Deaf individuals. Many medical settings attempt to shift the cost onto the patient or deny the patient outright to bring their own interpreter.

The recent updates to the Section 504 regulations strengthened protections against these types of discrimination.^[39]  We hope to see California enforce these regulations with rigor and uphold the critical rights of disabled people accessing health care.

Telehealth has significantly increased healthcare access for people with disabilities. During the COVID-19 pandemic, telehealth usage was higher among people with disabilities compared to those without, providing a vital alternative when in-person visits were limited. In particular, people with mobility disabilities had the highest rates of telehealth use, while those with hearing disabilities reported the lowest rates, underscoring the need for accessible telehealth platform designs that support various communication needs.[40]

Recent data from the UCLA Center for Health Policy Research shows that nearly 47% of California adults used telehealth in 2022, highlighting its critical role in expanding access to care. Usage was exceptionally high among older adults and those with both Medicare and Medicaid coverage. The flexibility of telehealth has been particularly beneficial for follow-up visits, managing chronic conditions, pain management, and accessing mental health services​.[41]

California has taken significant steps to maintain telehealth accessibility beyond the COVID-19 emergency. The state has committed to continuing many telehealth policies established during the pandemic, including coverage of video and audio-only telehealth across Medi-Cal services. In the event the telehealth federal provisions are rescinded, California must continue to support telehealth access and services.

Children with disabilities need timely and affordable access to specialized health care.

Achieving disability equity begins with our youngest Californians. Nearly 16% of all California’s children under 18 have special health care needs and require more health care services than those of their peers.[42] Only 27.3%-34.6%[43] of children enrolled in Medi-Cal receive screening for developmental, behavioral, and social delays by age 3. This represents untold lost opportunities for early intervention and treatment. Challenges in Medi-Cal disproportionately impact children of color and children living in poverty (81% of non-elderly Medi-Cal enrollees are people of color).[44]

Children qualifying based on their condition or disability receiving care in the California Children’s Services program within the Medi-Cal program encounter significant ongoing challenges accessing services and coordinated care. Families continue to experience wait times for specialty care and difficulty securing DME and private-duty nursing care. Additionally, youth struggle with transition to adulthood in Medi-Cal.

Health insurance fails to meet the needs of wheelchair users.

Despite the requirements of the Affordable Care Act, disabled Californians who use customized wheelchairs continue to face insurance coverage denials and caps for their medically necessary wheelchairs and wheelchair repairs by qualified health plans throughout the state. Most cannot afford to pay out of pocket for these essential mobility devices. As a result, disabled Californians go without appropriate wheelchairs or decline employment or advancements in employment so that they can maintain income eligibility for Medi-Cal and its wheelchair coverage. This needs to stop. California must enact a coverage mandate for qualified health plans to cover medically necessary wheelchairs together with repairs and accessories.

Algorithmic bias threatens to embed discrimination into every aspect of our health care system.

As health care systems increasingly rely on artificial intelligence (AI) to make day-to-day decisions, we need to limit the potential for biased algorithms to make life-or-death decisions. AI models have already demonstrated ableist biases — biases that can prove deadly and injurious to people with disabilities.^[45] For example, private insurers are already using AI to deny claims, overriding physicians’ determinations of what is necessary medical care.^[46] With emerging legislation attempting to rein in the potential adverse effects of this technology, disability must be centered in the conversation.

California Department of Public Health (CDPH) needs to do more to uphold the civil rights of people with disabilities.

COVID-19 identified long-standing public health policy problems, including highlighting that people with disabilities are frequently at increased risk from multiple kinds of viruses and infections, and tend to not get needed accommodations in healthcare settings (i.e., appropriate medical transportation, access to home vaccination, policy protections for people with disabilities who require personal care assistants in hospitals and institutionalized settings, or that mask requests will be honored as accommodation requests). CDPH enforcement workers must be trained and able to enforce civil rights requirements in the hospitals and other provider entities over which CDPH has jurisdiction.

California fails to use proven public health tools to mitigate COVID-19 transmission.

In January 2024, CDPH revoked the last of its meager remaining COVID-19 protections by shortening guidance on the isolation period for a positive COVID-19 test from 5 days to 0 days. This decision devalues disabled lives. This decision was made during the second highest COVID-19 spike ever, while Californians died daily from the virus and millions across the nation face lifelong disability from long-COVID. CDPH needs to consider high-risk people and the needs of disabled Californians in implementing policies that protect people from the deadly and disabling virus.

Masks are one of the most important tools as high-risk people navigate the ongoing pandemic. However, the University of California system recently joined in a wave of mask bans. Many disabled people need masks for health and safety. Restrictions on wearing masks harm disabled people by increasing surveillance and policing, inviting harassment and invasive medical questions, and generally discouraging mask-wearing.[47]

Disability demographic data is largely absent in California’s public health system.

CDPH, along with DHCS and the UCLA Center for Health Policy Research, runs the California Health Interview Survey. Currently, this survey lacks needed disability data, as it is limited to a few disability types and does not collect data across disability types.[48] This survey should collect far more information about people with disabilities to ensure disabled people are included in public health measures. Local public health departments need current and accurate information to meet the needs of people with disabilities in emergency and non-emergency situations.

Huge gaps remain in accessible transportation.

Many disabled Californians struggle to find accessible transportation. This includes accessible ride-share vehicles, taxi cabs with drivers who are trained to assist passengers with disabilities, and public transit options. Nearly half of the requests from disabled riders for rideshare services go unanswered.[49]

Disability organizations have sued Uber and Lyft for violations of disability rights laws. Many of these same organizations have tried to work closely with Uber and Lyft to ensure that they include people with disabilities in their planning process and structure. Advocates will continue to put pressure on all parties involved to ensure that disabled people are given accessible options for ground transportation. This issue is one of equity, especially because many disabled people are unable to drive and/or have a difficult time finding accessible parking spots.

California’s many public transportation systems frequently lack critical accessibility infrastructure. Discriminatory attitudes are pervasive across drivers, operators, and leadership, resulting in either a lack of service or mistreatment of people with disabilities. This level of discrimination is harmful and can cause disabled people to miss critical appointments, flights, meetings, job interviews, employment opportunities, or just time out with friends, family, and general recreation. Additionally, many transportation systems do not adequately engage disabled people in planning processes — resulting in inaccessible systems, including trains and buses with access challenges, notification, signage, and wayfinding access issues, and inaccessible fare and payment systems or inequitable policies.

Paratransit is an important tool for many disabled people. However, it is not equitable to force disabled people to rely on paratransit due to a lack of access to other forms of transit. Paratransit systems have limitations, such as that they are often not a reliable source of day-to-day transportation.[50] Paratransit is different from other forms of transit in that it requires reservations (sometimes 48 hours in advance) and scheduling, and wait times often reach unacceptable levels, leaving riders stranded. In addition, many paratransit systems severely penalize cancellations.

Autonomous vehicles are starting to become more popular, especially within major cities in California. Disability advocates have pushed policies requiring accessible autonomous vehicle availability. California must engage disabled people in conversations regarding autonomous vehicles to ensure disabled people have equal access to autonomous vehicle technology as it becomes increasingly available.[51]

There is no debate that accessible transportation needs to be reformed and improved. The state, through numerous initiatives, has a well-documented understanding of the gaps in this service area. Despite these efforts, no improvements have been made. Transportation services for disabled riders have remained inadequate for decades while the rest of the transportation system benefits from improved policies and increased funding.

California is behind in compliance with the National Voter Registration Act (NVRA).

Designated state agencies must ensure full compliance with the NVRA’s mandates. By improving compliance, we can increase voter registration rates for people with disabilities and other underrepresented groups.

We need significantly increased state budget allocations toward voter education and outreach, especially in addressing the information needs of voters with disabilities. Improving awareness about accessible voting options will ensure that all voters have the knowledge and resources to participate fully in the electoral process.

Voter’s Choice Act (VCA) implementation is incomplete.

The effective implementation of the Voter’s Choice Act (VCA) is an important accessibility issue. The VCA expands early voting and offers more flexible voting opportunities to voters in participating counties. In particular, the state needs better implementation of the VCA’s robust public input process on election planning and full implementation of the law’s many accessible voting requirements. Additionally, only half (28) of California’s counties fully participate in the VCA.

Accessible Voting Options are still missing for some disabled Californians.

Electronic ballot return for individuals with print disabilities is an essential step towards creating a fully accessible and equitable voting environment. Voters with print disabilities, including those who are blind or have low vision, cannot currently return a vote by mail ballot privately and independently. California should implement voting technology that allows electronic ballot returns. Electronic ballot return is a proven technology in use in numerous states.

California lacks adequate disaster recovery funds.

The state should ensure enough disaster recovery funds are available in instances when the federal government does not provide a locale with a federal disaster declaration. When the federal government fails to declare a disaster, the Federal Emergency Management Agency (FEMA) does not provide aid to survivors. Disaster funds are crucial to recovery for the uninsured and underinsured; without assistance, people surviving on limited incomes are not able to pay for necessary home repairs or relocation or replace necessary medical equipment.

Insurance companies are leaving the state and dropping Californians at an alarming rate.

Disasters can reduce the already limited accessible, affordable housing supply. Following a climate disaster, such as a wildfire, people with disabilities face greater challenges in finding housing that is both accessible and affordable. The available insurance options, including the FAIR plan, are still too expensive for most people on limited incomes and fail to provide full coverage. The state needs to work with the insurance industry to keep companies in the state and ensure affordable coverage is available to all homeowners.

Web content and other technology fall short of accessibility standards.

California law currently mandates that public websites and other government technology be accessible to people with disabilities.[52] However, disabled individuals in California still lack equal access to most websites and governmental technology. This is due to several factors, including the increasing trend of outsourcing governmental functions to private technology vendors. Many website and software developers are not being held accountable to clear web accessibility standards and procurement requirements. Recent litigation illustrates the problem. STATE OF CALIFORNIA, ex rel. BASHIN v. Conduent, Inc., revealed that private party web developers overpromised the accessibility of the Department of Park’s $66 million procurement of an outsourced reservation website operated by private parties.[53] Fowler v. PSI Services, LLC, involved the Department of Insurance outsourcing the administration and development of its online license exams to a private vendor that had allegedly not incorporated accessible design under the contract. [54]  Moreover, according to the 2024 Web Accessibility In Mind Million Report, government websites had an average of 35.7 digital accessibility errors based on the Web Content Accessibility Guidelines.[55] Similar problems exist in the private market as traditional brick-and-mortar businesses conduct less technology development in-house and outsource the operation to technology platform developers.

We call upon the state to ensure that the technology it procures, funds, uses, maintains, and/or develops is completely accessible to people with disabilities to bolster itself as a leader in digital access. Further, stricter monetary penalties and increased private enforcement against private contractors are necessary to keep pace with increasing privatized governmental technology operations.

California is a “sanctuary state” that still struggles to acknowledge and prioritize immigrants with disabilities as community members needing support.

California has the highest population of immigrants among states in the nation[56] and therefore has a responsibility to work in community with immigrants, especially immigrants with disabilities. Very often efforts and policies to advance the health and safety of immigrants are at the mercy of partisan politics. This back and forth does not provide our immigrant neighbors, especially those with disabilities, with the feeling of security to thrive in our communities.

Immigrants with disabilities are still first in line to have services targeting their assistance threatened.

As a state that regularly touts itself as progressive on immigration issues, California still has ground to cover in the support of immigrants with disabilities. Earlier this year, following the announcement of the state budget deficit, the state released its budget revision that would make cuts to several programs that benefitted immigrants with disabilities. These cuts included funding to CSU legal clinics, in-home support services (IHSS), expanded food benefits, and case management for unaccompanied children.[57] A strong push from the community and advocates helped to preserve the legal clinics, IHSS for immigrants, and a commitment to expanded food benefits, although delayed for two years.[58] Unfortunately, the aid and case management for unaccompanied minors’ program, Children Holistic Immigration Representation Project (CHIRP), was not renewed, leaving this population without services.[59] This is especially troubling as many unaccompanied children traveling to the US suffer from physical and mental issues as a result of the trauma of their journey. They also are a population that is particularly vulnerable to being exploited in dangerous jobs that violate labor laws.[60]

Immigration status is still being shared with federal agencies which creates a jail/prison to deportation pipeline that disproportionately affects immigrants with disabilities.

California has made great efforts to close for-profit immigration detention facilities in the state with the passage of AB 32.[61] Unfortunately, that effort was unsuccessful as federal appeals courts found the law unconstitutional.[62] While that avenue is closed for the moment, California has other options to help immigrants from being fast-tracked out of their communities and the country. The Vision Act (AB 937) was a proposal to fix the sharing of information like immigration status with federal agencies to keep people in their communities following the completion of their sentences.[63] The bill failed to get the necessary votes in 2022, and that failure continues to affect immigrant communities. Immigrants with disabilities continue to be disproportionally affected by this information sharing because they have a lot to lose in services that are provided in the community in California. Furthermore, the process generally leads to people being sent to immigration detention facilities where the conditions are inadequate to provide services to people with disabilities.

• Cal Voices
• California Council of the Blind
• California Foundation for Independent Living Centers
• Choice in Aging
• The Coelho Center for Disability Law, Policy and Innovation
• Disability Rights California
• Disability Rights Education & Defense Fund
• National Federation of the Blind of California
• NorCal Services for Deaf & Hard of Hearing
• Painted Brain
• Youth Justice Education Clinic at Loyola Law School

If your organization supports the findings in this report and the need to prioritize disability rights in statute and enforcement, you can sign on using this form.

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[1] “Disability & Health U.S. State Profile Data: California.” Centers for Disease Control and Prevention, 12 May 2023, www.cdc.gov/ncbddd/disabilityandhealth/impacts/california.html.

[2] “Children with Special Health Needs: California.” Kids Data, Population Research Bureau, 2022. https://www.kidsdata.org/export/pdf?cat=14.

[3] Hurst, Andrew. “Best States for Living with a Disability” Policygenius, 17 Apr. 2024, www.policygenius.com/disability-insurance/the-best-states-for-living-with-a-disability/#what-makes-a-state-better-or-worse-for-residents-with-disabilities.

[4] Hassan, Zeenat. “Letter in Support of an Opinion from the Attorney General on Remote Participation in Brown Act Meetings as a Reasonable Accommodation under the Americans with Disabilities Act.” 1 Feb. 2024. Received by Catherine Bidart, Deputy Attorney General.

[5] Bion, Xenia Shih. “Life Experiences Help Peer Counselors Assist Others with Mental Health Issues” California Health Care Foundation, 5 Aug. 2019, https://www.chcf.org/blog/life-experiences-help-peer-counselors-assist-others/.

[6] Morris, Nathaniel P. “Taking an Evidence-Based Approach to Involuntary Psychiatric Hospitalization” Pub Med, 1 Apr. 2023, https://pubmed.ncbi.nlm.nih.gov/36128697/.

[7] “Annual Disability Statistics Collection, Section 6.” Center for Research on Disability, May 2022, www.researchondisability.org/ADSC. (last visited May 7, 2024) (noting that in 2022, 24.9% of disabled people were living in poverty compared to 10.1% of people without disabilities).

[8] “Priced Out: The Housing Crisis for People with Disabilities” Technical Assistance Collaborative, 2024, www.researchondisability.org/ADSC.

[9] Blasi, Gary, et al. Basic Income Grants to Reduce Homelessness in Los Angeles (2024), USC, School of Social Work, Etc., Apr. 2024, https://hpri.usc.edu/wp-content/uploads/2024/04/Basic-Income-Grants-to-Reduce-Homelessness-in-Los-Angeles_draft.pdf.

[10] “California Civil Rights Department Finds Widespread Housing Discrimination Against Federal Housing Choice Vouchers.” State of California, Civil Rights Department, 17 Oct. 2022, calcivilrights.ca.gov/wp-content/uploads/sites/32/2022/10/Fair-Housing-Testing-and-Housing-Choice-Voucher10.17.22PR.pdf.

[11] Kushel, M., Moore, T., et al., University of California, San Francisco Benioff Homelessness and Housing Initiative. June 2024 Toward a New Understanding: The California Statewide Study of People Experiencing Homelessness, UCSF Benioff Homelessness and Housing Initiative, homelessness.ucsf.edu/our-impact/studies/california-statewide-study-people-experiencing-homelessness.

[12] ”Certiorari to the United States Court of Appeals for the Ninth Circuit” City of Grants Pass, Oregon v. Johnson. 28 June 2024, https://www.supremecourt.gov/opinions/23pdf/23-175_19m2.pdf.

[13] Luna, Taryn. “Newsom threatens to take money from counties that don’t reduce homelessness” Los Angeles Times, 8 Aug. 2024, https://www.latimes.com/california/story/2024-08-08/gavin-newsom-homelessness-fight-california-counties.

[14] Raphling, John. “Criminalizing Homelessness Violates Basic Human Rights” The Nation, 5 July 2018, https://www.hrw.org/news/2018/07/05/criminalizing-homelessness-violates-basic-human-rights?gad_source=1&gclid=EAIaIQobChMI06_LsaqTiAMVA87CBB0SlS_lEAAYASAAEgK9V_D_BwE.

[15] @HDizz. X. 22 Aug 2024, https://x.com/dizz_h/status/1826687972827431371.

[16] Males, Mike. “Stop Lying About Crime in California” Center on Juvenile & Criminal Justice, 31. Jul 2024, https://www.cjcj.org/reports-publications/report/stop-lying-about-california.

[17] “California to Make Largest-Ever Investment to Combat Organized Retail Crime.” State of California, Governor Gavin Newsom, Gov.Ca, 9 Sept. 2023, www.gov.ca.gov/2023/09/12/ort-grants/.

[18] Thompson, Vilissa. “Understanding the Policing of Black, Disabled Bodies” Center for American Progress, 10 Feb. 2021, https://www.americanprogress.org/article/understanding-policing-black-disabled-bodies/.

[19] Disability Rights Groups Submit Letter to LA County District Attorney Urging Dismissal of All Charges with Prejudice Against Isaias Cervantes, 4 Jan. 2022, www.disabilityrightsca.org/latest-news/disability-rights-groups-submit-letter-to-la-county-district-attorney-urging-dismissal; “Disability Rights California Calls for Change and Accountability Following Police Shooting of Teen with Disability.” Disability Rights California, 15 Mar. 2024, www.disabilityrightsca.org/latest-news/disability-rights-california-calls-for-change-and-accountability-following-police; see also Amicus Curiae Brief in City and Cty. of San Francisco v. Sheehan, No. 13-1412 (Feb. 13, 2015), https://www.aclu.org/cases/city-and-county-san-francisco-v-sheehan?document=city-and-county-san-francisco-v-sheehan-amicus-brief.

[20] “A Different Conversation about Solitary Confinement.” Disability Rights California, 2 Aug. 2023, www.disabilityrightsca.org/latest-news/a-different-conversation-about-solitary-confinement.

[21] Statista Research Department. ”Number of Hate Crime Offenses in the United States in 2021, by State.” Statista, 5 July 2024, https://www.statista.com/statistics/737930/number-of-hate-crimes-in-the-us-by-motivation/.

[22] “Hate Crimes in California.” California State Auditor, May 2018, https://information.auditor.ca.gov/reports/2017-131/summary.html.

[23] Mcinerney, Mary. “School of Education Students Fill a Need in Mental Health Care.” University of San Francisco, 19 Jan. 2023, www.usfca.edu/news/students-fill-mental-health-need#:~:text=For%20children%2C%20the%20shortage%20is,is%20250%20students%20per%20counselor.

[24] Turner, Cory. “Students with Disabilities are Missing School Because of Staff Shortages” NPR, 14 May 2024, https://www.npr.org/2024/05/14/1251408094/students -with-disabilities-are-missing-school-because-of-staff-shortages.

[25] “A Guide to the Individualized Education Program” US Department of Education, www2.ed.gov, https://www2.ed.gov/parents/needs/speced/iepguide/index.html Accessed September 2024

[26] 1 “Overview of Juvenile Justice System and Education Services in Juvenile Facilities” Legislative Analyst’s Office, 17 Apr. 2023, https://lao.ca.gov/handouts/crimjust/2023/Juvenile-Justice-Education-041723.pdf.

[27] Robert, Amanda. “Troubling Treatment: Efforts Are Underway to Reform Teen Behavioral Programs.” ABA Journal, 1 Aug. 2021, p. 53, www.abajournal.com/magazine/article/efforts-are-underway-to-reform-teen-behavioral-programs.

[28] California Family Permanency and Support Services Branch, Out of State Placements January 1, 2019-December 31, 2022, California Department of Social Services (data forwarded by Abby Mann with Unsilenced).

[29] Regan-Adkins v. San Diego Unified Sch. Dist., 37 Fed. Appx. 930 (9th Cir. 2002)

[30] “Inclusion Works! Creating Child Care Programs That Promote Belonging for Children with Disabilities” California Department of Education, 2021, https://www.cde.ca.gov/sp/cd/re/documents/inclusionworks2ed.pdf.

[31] “Position Statement on Inclusion.“ National Association of the Deaf,  https://www.nad.org/about-us/position-statements/position-statement-on-inclusion/#:~:text=The%20NAD%20believes%20that%20ALL,%2C%20social%2C%20and%20emotional%20development.

[32] “Report 5 – Disability Parity by Department.” California Department of Human Resources, 2024. https://www.calhr.ca.gov/Pages/statewide-reports.aspx

[33] “Resolution 2022-06 Concerning Sufficient Blind Board Representation” National Federation of the Blind California, https://www.nfbcal.org/resolution-2022-06-concerning-sufficient-blind-board-representation/.

[34] “Governor Newsom Strengthens State’s Commitment to a California for All.” Governor Gavin Newsom, https://www.gov.ca.gov/2022/09/13/governor-newsom-strengthens-states-commitment-to-a-california-for-all/.

[35] Leiner, William, et al. “From Navigation to Transformation: Addressing Inequities in California’s Regional Center System through Community-Led Solutions.” Disability Rights California, 10 Jan. 2023, www.disabilityrightsca.org/latest-news/from-navigation-to-transformation-addressing-inequities-in-californias-regional-center.

[36] “California: National Core Indicators, State Report: 2017-18.” California | National Core Indicators, legacy.nationalcoreindicators.org/states/CA/report/2017-18/.

[37] “Priced Out: The Housing Crisis for People with Disabilities.” Technical Assistance Collaborative, www.tacinc.org/resources/priced-out/.

[38] “Mudrick, Nancy R., et al. “Physical Accessibility in Primary Health Care Settings: Results from California on-Site Reviews.” Disability and Health Journal, vol. 5, no. 3, July 2012, pp. 159, 163–64, https://pubmed.ncbi.nlm.nih.gov/22726856/.

[39] HHS Finalizes Rule Strengthening Protections Against Disability Discrimination, U.S. Department of Health and Human Services (HHS) & Office for Civil Rights (OCR), 1 May 2024, www.hhs.gov/about/news/2024/05/01/hhs-finalizes-rule-strengthening-protections-against-disability-discrimination.html.

[40] Karimi, Madjid et al. “Trends and Disparities in Pandemic Telehealth Use among People with Disabilities.” Assistant Secretary for Planning and Evaluation, 14 May 2024. https://www.aspe.hhs.gov/sites/default/files/documents/d70dae84a7988837d3819529988d4919/telehealth-disability-ib.pdf.

[41] Tan, Sean. “Telehealth and the Future of Health Care Access in California.” UCLA Center for Health Policy Research, Oct. 2023. https://healthpolicy.ucla.edu/sites/default/files/2023-09/telehealth-fact-sheet-october-2023.pdf.

[42] “Children with Special Health Care Needs” California Department of Public Health, Center for Family Health, Maternal, Child and Adolescent Health Division, 2021, https://www.cdph.ca.gov/Programs/CFH/DMCAH/surveillance/Pages/Children-and-Youth-with-Special-Health-Care-Needs.aspx.

[43] “Quality of Care for Children in Medicaid and CHIP: Findings from the 2022 Child Core Set: Chart Pack.” Center for Medicare & Medicaid Services, Jan 2024, https://www.medicaid.gov/medicaid/quality-of-care/downloads/2022-child-chartpack.pdf.

[44] “Medicaid in California Fact Sheet” Kaiser Family Foundation, Aug. 2024, https://files.kff.org/attachment/fact-sheet-medicaid-state-CA.

[45] Fetzer, Mary. “Trained AI Models Exhibit Learned Disability Bias, IST Researchers Say.” Penn State University, ​Penn State News, 30 Nov. 2023, www.psu.edu/news/information-sciences-and-technology/story/trained-ai-models-exhibit-learned-disability-bias-ist/.

[46] Napolitano, Elizabeth. “Lawsuits Take Aim at Use of AI Tool by Health Insurance Companies to Process Claims.” CBS News, CBS Interactive, 18 Dec. 2023, www.cbsnews.com/news/health-insurance-humana-united-health-ai-algorithm/.

[47] “DREDF, DRC and 89 Organizations Condemn Mask Bans and Urge Lawmakers Not to Adopt Them to Protect the Right of People with Disabilities to Participate in the Community Safely” Disability Rights California, 31 Jul. 2024, https://www.disabilityrightsca.org/latest-news/dredf-and-drc-condemn-mask-bans-and-urge-lawmakers-not-to-adopt-them-to-protect-the.

[48] ”CHIS Methodology Reports Repository” UCLA Center for Health Policy Research, https://healthpolicy.ucla.edu/our-work/california-health-interview-survey-chis/chis-design-and-methods/chis-methodology-reports-repository.

[49] Koury, Renee. “Data Shows about Half of Calls for Wheelchair Rideshares Go Unanswered, Stranding Disabled Users.” ABC7 San Francisco, 14 July 2023, abc7news.com/wheelchair-accessible-vehicle-disabled-transportation-uber-lyft/13499065/.

[50] “‘Premium Charges’ for Paratransit Services.” U.S. Department of Transportation, Federal Transit Administration, 27 Feb. 2020, www.transit.dot.gov/regulations-and-guidance/civil-rights-ada/premium-charges-paratransit-services.

[51] Stine, Alison. “The Promise and Problems of Self-Driving Cars for the Disabled Community – Non Profit News: Nonprofit Quarterly.” Non Profit News | Nonprofit Quarterly, 25 Sept. 2023, nonprofitquarterly.org/the-promise-and-problems-of-self-driving-cars-for-the-disabled-community/.

[52]  Cal. Gov. Code §§11135 & 7405; AB 434; Unruh Civil Rights Act; Disabled Persons Act.

[53]  Case No. RG18888208 (settled in 2023)

[54]  Case No: 21CV000126 (settled in 2024)

[55] “The WebAIM Millionthe 2024 Report on the Accessibility of the Top 1,000,000 Home Pages.” WebAIM, 28 Mar. 2024, webaim.org/projects/million/.

[56] Moslimani, Mohamad. ”What the Data Says about Immigrants in the U.S.”  27 Sept. 2024, https://www.pewresearch.org/short-reads/2024/09/27/key-findings-about-us-immigrants/#:~:text=In%202022%2C%20most%20of%20the,4.5%20million%20or%2010%25.

[57] Plevin, Rebecca. “Newsom’s Budget Plan Saves Vital Programs for Immigrants, but Kids and Hungry Seniors May Suffer” Los Angeles Times, 26 June 2024, https://www.latimes.com/california/story/2024-06-26/gavin-newsoms-budget-agreement-is-a-mixed-bag-for-californias-immigrant-communities.

[58] Id.

[59] Id.

[60] Fry, Wendy. “Unaccompanied Immigrants” Cal Matters, 30 July 2024, https://laist.com/brief/news/california-teen-deportation-program.

[61] “Governor Newsom Signs AB 32 to Halt Private, For-Profit Prisons and Immigration Detention Facilities in California” Governor Gavin Newsom, https://www.gov.ca.gov/2019/10/11/governor-newsom-signs-ab-32-to-halt-private-for-profit-prisons-and-immigration-detention-facilities-in-california/.

[62] Castello, Andrea. “California Tried and Failed to Ban For-profit ICE Detention Centers. What Does that Mean for Other States?” Los Angeles Times, 28 June 2024, https://www.latimes.com/politics/story/2023-06-28/california-private-detention-ban-overturned-future.

[63] The VISION Act (AB 937-Carrillo) http://www.iceoutofca.org/ca-values-act-sb54-408546.html.